MEDICARE: CAROL N ROWSEMITT PHD, RN, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	556135	CA

General Provider Information

NPI Number	:	1962407981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL N ROWSEMITT PHD, RN, FNP

Provider Business Mailing Address
First Line	:	1845 QUAIL DR
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93405-6341
Country	:	US
Telephone Number	:	805-782-9704
Fax Number	:	805-773-3120

Provider Business Practice Location Address
First Line	:	855 4TH ST
Second Line	:	# 2
City	:	PISMO BEACH
State	:	CA
Zip	:	93449-3102
Country	:	US
Telephone Number	:	805-773-3130
Fax Number	:	805-773-3120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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